Objective:To analyze relationship between early intervention treatment and long-term prognosis in pa-tients with acute non-ST segment elevation myocardial infarction (NSTEMI).Methods:A total of 948 acute NSTE-MI patients were enrolled.According to NSTEMI intervention treatment timing,they were divided into early inter-vention group (received intervention treatment within 48h n=411,)and late intervention group (received interven-tion treatment after48h,n=537).According to TIMI risk score,the two groups were further divided into low risk subgroup,medium risk subgroup and high risk subgroup,the clinic long-term outcome was compared among all groups.Results:Compared with late intervention group,during one year follow-up,there were significant reduction in mortality during hospitalization (4.8% vs.2.2%)and incidence rate of major adverse cardiovascular events (MACE,13.4% vs.10.0%)in early intervention group,P <0.01 both;in early intervention group,mortality dur-ing hospitalization of low and medium risk patients was significantly lower than that of high risk patients (3.3% vs. 8.9%,P <0.01).Multi-factor regression analysis indicated that aged,high Killip class,reduced left ventricular e-jection fraction,high TIMI risk score and late intervention treatment were independent risk factors for clinic long-term outcome in NSTEMI patients (OR=1.027~2.079,P <0.05 or <0.01).Conclusion:Early intervention treat-ment can improve prognosis in NSTEMI patients.

Bile Duct Neoplasms ; surgery ; Bile Ducts ; pathology ; surgery ; Bile Ducts, Intrahepatic ; pathology ; surgery ; Biliary Tract Diseases ; surgery ; Biliary Tract Surgical Procedures ; methods ; trends ; Cholecystectomy, Laparoscopic ; methods ; trends ; Cholelithiasis ; surgery ; Humans

Hearing ; Hearing Aids ; Prostheses and Implants

Carotid Body Tumor ; genetics ; Humans ; Paraganglioma ; genetics

Anti-Bacterial Agents ; therapeutic use ; Endophthalmitis ; complications ; drug therapy ; Humans ; Infant, Newborn ; Meningoencephalitis ; complications ; drug therapy ; Suppuration

Objective To study the etiology,clinical presentation,MR images,treatment and prog-nosis of spontaneous spinal epidural and subdural hematoma.Methods From1995to2002,6cases diag-nosed as spontaneous spinal epidural and subdural hematoma were reviewed retrospectively.All of the pa-tients were males aging from30to68years with an average of 47years.The onset was acute while the pa-tients were in resting or light activity without prior history of any infection,administration of drugs or trau-ma.One patient had the history of hypertension,and another one was found to have diabetes after admission.The clinical characteristics were sudden pain involving neck,shoulder,chest and back,then dysfunction of motion and sensation of extremities and sphincter within few minutes.4cases of spontaneous spinal epidural hematoma were located at T 5~6 ,T 2~4 ,C 4~5 and C 6 ~T 1 respectively,and2cases of spontaneous spinal subdu ral hematoma at C 7 ~T 1 and C 7 ~T 2 respectively.Results All cases were proved with surgery and pathology.MR imaging showed occupying mass in the posterior or posteriolateral region inside the spinal canal.T 1 -weighted imaging was most useful owing to its typical signal changes with the hematoma.T 2 -weighted gra-dient echo sequence was capable to identify epidural and subdural spinal hematoma.Total laminectomy and hematoma debridement were performed.The outcome was closely related to the interval between the onset and surgery.The patients were followed up from6to18months with an average of 10months.All cases showed no significant improvement of spinal cord function except 5cases with incomplete recovery of sphincter function.Conclusion Spontaneous spinal epidural and subdural hematoma are rare entities.MRI is a most helpful diagnostic tool for this disorder.It should be stressed that early diagnosis and prompt surgical intervention are of great importance for prognosis of spontaneous spinal epidural hematoma.

The discovery of limbal stem cells is the key advancement in ophthalmology in the 20th century.Many clinical researches have proved that limbal stem cells transplantation is an effective method to treat severe ocular surface diseases.However, some important issues associated with the identification,isolation,standardized culture in vitro and differentiation after transplantation are still not clear and need to be paid more attention.Strengthening the underlaying research in this field will play important role in treating corneal blindness.

Objective This study aims to observe and analyze the result of implementing health management and intervention for chronic Keshan disease treatment. Methods Certain amounts of chronic Keshan disease patients in Keshan disease area were chosen and given health management and treatment intervention including primarily pharmacological treatment for the chronic congestive heart failure together with health education and life style instruction. From 2006 to 2008, three interventions were conducted every six month. Electrocardiogram description, proportion of heart to chest, classification of heart function, types of Keshan disease and labour capacity at the initial and the last stage of the intervention were taken as judging indexes. If one of the indexes was improved then the intervention will be regarded as effective. The number of effective cases and effective rate were counted in order to observe the impact of intervention times and different medicine on intervention results. Results Altogether 345 Keshan disease patients were involved in the study, among them 207 were effective, the effective rate was 60%(207/345). One hundred and eighty were involved in the intervention for once, and the effective rate was 44%(79/180). Ninty-one took part in the intervention twice, and the effective rate was 66%(60/91). Seventyfour attended the intervention for three times, and the effective rate was 92% (68/74). There were significant difference among groups of different intervention times (χ2 = 52.16, P < 0.01), and the effective rate increased with increased intervention times. Three times were higher than that of one or two times (χ2= 15.81, 49.56, all P< 0.0125). Twice were better than once(χ2 = 11.76, P < 0.0125). There were significant difference among groups of different medicine groups(χ2 = 19.56, P< 0.01). Among different medicine groups, the efficacy of angiotensin converting enzyme inhibitor(ACEI) group was the highest 77%(82/106) while the cardiotonic medicine group was 50%(47/94) and cardiac muscle nutrition poisons was 54% (78/145). The efficacy rate of ACEI group was higher than that of cardiotonic medicine group and cardiac muscle nutrition poisons(χ2 = 16.28, 14.71, P< 0.0125). Conclusions The implement of health management and treatment intervention to Keshan disease patients is of great significant in improving the healthy condition of Keshan disease patients. Health education and life-style instruction as well as the use of ACEI, β-blockers and diuretic have comparatively obvious effect on treatment of chronic Keshan disease congestive cardiac failure.

Objective By X-ray measurement of metacarpal and phalange bones in the right hand of adult patients with Kaschin-Beck disease in Qinghai Province,to provide anatomic data and information for clinic diagnosis of the disease and application of hand surgery.Methods Fifty-four cases of adult patients with Kaschin-Beck disease,who came from Guide County and Xinghai County in Hainan Prefecture,Qinghai Province,were selected as investigation subjects,then their right hand X-ray film were taken,metacarpal and phalange bones were measured by electronic digital vernier caliper.All data were analyzed with SPSS 19.0.Results The axis length of the metacarpal bones was in the order of:the 2nd metacarpal ＞ 3rd metacarpal ＞ 4th metacarpal ＞ 5th metacarpal ＞ first metacarpal.The axis length of proximal phalange bones was in the order of:the middle finger proximal ＞ ring finger proximal ＞ index finger proximal ＞ little finger proximal ＞ proximal thumb,while the middle,distal phalanx axis length varied greatly.The length of metacarpal and phalange bones of all male was longer than that of female(all P ＜ 0.01).The width of the metacarpal bones was in the order of:the 2nd metacarpal ＞ 3rd metacarpal ＞ 5th metacarpal ＞ 4th metacarpal.The width of the 2nd-5th metacarpal of male and female was (8.57 ± 0.90),(8.25 ± 0.80),(6.84 ± 0.69),(7.70 ± 0.77)mm and (7.40 ± 0.74),(7.36 ± 0.70),(6.00 ± 0.57),(6.62 ± 0.65)mm,respectively,the differences were significant(t =5.24,4.32,4.85,5.55,all P ＜ 0.01).The matacarpal bone index of female[(8.23 ± 0.90)mm] was significantly larger than that of male[(7.61 ± 0.76)mm,t =2.73,P ＜ 0.01].Conclusion X-ray measurement of hand may provide reference information for diagnosis of Kaschin-Beck disease and determination of metacarpal and phalange length in hand surgery.

Objective By investigating newly diagnosed Kashin-beck disease,to understand distribution range,epidemic intensity and prevalence trend of Kashin-Beck disease(KBD)in Xinghai County.Method According to monitoring method on national KBD,we carried on epidemical investigation,clinical examination and X-ray photograph on school children aged 7-13 years in 6 villages from 4 towns in Xinghai County,and hair,grain,water and soil were sampled to detect selenium content using naphthalene fluorescence.Resuit Three hundred and seventy.three school children aged 7-13 years underwent the clinical examination,the prevalence rate was 12.06%(45/373);347 school children were went on X-ray,the detection rate of X-ray was 21.61%(75/347).The selenium content was the lowest in Quanqu Village,Ziketan Town,which were(77.70±42.04),(7.44±6.93)μg/kg respectively;the selenium content Was highest in Cainaihai Village,Qushian Town,which were(103.88±58.57),(29.58±24.11)μg/kg respectively;level of in internal and external environment in 4 KBD region were all low.Conclusion These four region are new KBD region.The prevalence state of KBD is serious,pathogenetic factor of Kashin-Beck disease is very active.